- Healthcare organizations should prioritize a system’s ability to facilitate EHR interoperability and seamless health data exchange when making health IT purchasing decisions, according to a new publication from the National Academy of Medicine (NAM.)
The publication outlines a multi-stakeholder approach to achieving widespread healthcare interoperability through the strategic acquisition of health IT solutions and devices capable of facilitating health data exchange between facilities, within healthcare organizations, and at the point-of-care.
Healthcare industry experts from NAM, Johns Hopkins Medicine, Emory University, the Department of Defense (DoD), ONC, the American Medical Informatics Association (AMIA), VA, and other institutions assisted in developing a roadmap to guide healthcare organizations toward improved interoperability through strategic health IT module procurement.
In the current EHR marketplace, healthcare organizations are encouraged to purchase health IT systems and health IT modules from different vendors. These vendors often come with proprietary interface technology, which can lead to data siloes and information blocking. Challenges with EHR interoperability can increase administrative burden on clinicians and worsen provider burnout, experts stated.
Implementing certain standards — or procurement strategies — during EHR selection and health IT module purchasing decisions may help organizations build up the interoperability of their digital infrastructure.
“In other industries that have achieved a high degree of IT interoperability, standards support the work, yet its achievement is also simultaneously driven by vendor action and the demand from purchasers and users of technology,” experts wrote in the report.
“In health care, leveraging procurement specifications remains an important yet underused approach to drive health care integration, quality improvement, and cost containment,” the team continued.
Forming organization-wide interoperability steering groups to guide health IT purchasing decisions may provide the governance infrastructure necessary to optimize health IT investments.
“The interoperability steering group will ideally be a standing organizational committee supported by and accountable to the health care organization’s top leadership,” stated experts.
The steering committee would oversee, coordinate, and evaluate a healthcare organization’s procurement framework. The group would also help to develop a long-range interoperability roadmap.
“The road map is a component of the organization’s multiyear procurement plan that pursues the vision for system openness and interoperability with incremental objectives and guideposts,” clarified experts.
The interoperability steering committee should also spearhead an interoperability needs identification process, experts recommended. Steering groups should engage key stakeholders during this needs assessment.
“This means documenting and visualizing the complex information and workflow interactions in a health care setting and the translation of these interactions to interoperability needs for new or upgraded health IT systems,” experts wrote.
Finally, the steering group should develop procurement specifications for inclusion in requests for proposal (RFPs) during future health IT purchasing processes. Committee members should incorporate various health data exchange standards, supporting resources, and reference architecture in procurement specifications.
“The ONC Interoperability Standards Advisory provides some useful resources, including best practice guidance on data exchange standards, production of security and patient privacy, implementation guides, and integration profiles as well as guidance on contracting with EHR vendors,” experts suggested.
Enabling a person or patient-centric healthcare model should be the ultimate goal for patients, providers, EHR vendors, and regulators.
EHR vendors and other health IT solutions providers can help to push interoperability forward by collaborating to develop an open architecture platform that leverages a small number of health data exchange standards. Standards development will require active participation from most health IT vendors to be successful.
“Software platform and application vendors should demonstrate how data captured from external sources can be integrated into clinical workflows, and the value of such integration,” recommended experts.
“Only when these use cases are adequately evaluated and their value widely replicated in multiple settings will providers demand interoperability and open solutions and reward vendors who embrace open architecture principles,” they continued.
EHR vendors also play a significant role in influencing the expectations and dynamics at play in the marketplace.
“Health IT system vendors should work together to agree upon the best industry standard exchange specifications and then make them available to their customers,” experts wrote.
Combined with policies and market incentives geared toward enabling true healthcare interoperability, strategic health IT system procurement may help to spur significant improvements in health data exchange.
“To ensure that health care dollars are spent in pursuit of health care delivery systems reaching desired levels of care quality, safety, and efficiency, interoperability must be a top priority,” said NAM President Victor J. Dzau.
“Only then will the health care industry begin to create truly integrated care systems that continuously provide better experiences for clinicians and patients while achieving better health and health care at a lower cost,” Dzau continued.